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精选精选*李祥全精选*WHATISPSHPSH：ParoxysmalSympatheticHyperactivityParoxysmal：阵发性SympatheticHyperactivity：交感活性增高精选*WHATISPSH交感神经副交感神经精选*WHATISPSH交感神经兴奋是一种应激反应，起到一定的机体保护作用精选*WHATISPSH交感兴奋时可有以下变化：心率加快胃肠道血管收缩呼吸增快汗腺分泌瞳孔扩大糖原分解膀胱逼尿肌松弛、括约肌收缩肌张力升高！准备战斗！精选*WHATISPSH精选*WHATISPSH平衡是机体正常的生理需求交感VS副交感精选*WHATISPSHPSH：unbalancedsympatheticsurgescausinghyperthermiadiaphoresistachycardiahypertensiontachypneadystonicposturingdevelopabruptlyandlastforashorttime精选*WHATISPSH精选*WHATISPSHcharacteristic：Thefirstepisodeoccurredonaverage5.9±3.7daysafterbraininjuryThedurationofeachepisodewasonaverage31min(range,15–50min)anditsfrequencywasonaverage5.6/day(range,3―8/day)Only20%ofpatientswhowerefollowedupat12monthsafterinjuryshowedcontinuedsignsofPSHYoungerageandmalegenderhavebeencitedasriskfactors精选*WHATISPSHcharacteristic：Increasesindopamine,adrenaline,andnoradrenalinelevelsduringtheepisodeshavebeenreportedPatientswhoexperiencePSHhaveworseGlasgowOutcomeScalescoresandworsefunctionalindependentmeasuresthantheirounterpartslongerICUstays,longerhospitalstay,moremechanicalventilationdays,moreinfectiousepisodes,moretracheostomy,andhigherhealthcarecosts精选*WHATISPSHPSHoccursinstages：asymptomaticduetosedation;onsetofsymptomclusters;declineinposturinganddystonia精选*ReasonforPSHCausedbyTBIsubarachnoidhemorrhageencephalitistumorshydrocephalusotherdiseases精选*MechanismsUnknownfunctionalorstructuraldisconnectionlesionsinthemesencephaloncausedisruptionsinrelayfromthemedulla/hypothalamusexcitatory–inhibitoryratio(EIR)modeldysfunctionofthediencephalic-brainsetminhibitorycenterthatnormallycontrolsafferentstimulusprocessinginthespinalcordoccurs精选*DiagnosticWorkupsExclusiondiagnosisInfectionsandsepsisshouldberuledoutinpatientsw
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